Development of the Nursing Service Management Model to Promote Self-Health among Palliative Care Patients and Caregivers in Songkhla Province Network

Abstract

This action research aimed to 1) manage a nursing service following the nursing service management model to promote self-health in palliative care patients and caregivers, and 2) study the result. The instruments consisted of a data collecting form, a focus group questionnaire, an assessment form on the ability for self-health, an assessment form on the outcome of nursing service and palliative care, as well as an assessment form on satisfaction. The collected data were analyzed using descriptive statistic information and qualitative information. The results showed as follows.

1. The problems and needs of the nursing service management model to promote self-health in palliative care patients and caregivers had 6 dimensions: health problems, beliefs, culture, finance, caregiver’s family and Network participation, and expectation of self-management.

2. The nursing service management model to promote self-health has contributed to the guideline of self-management in palliative care and caregivers. This was the record that the nursing team can use as the individual daily care plan (ICP) for a nurse (SM F1), it has covered 5A (Assess, Advise, Agree, Assist, and Arrangement), which are: a) the livelihood idea of service receiver and their family, b) The livelihood problem and needs, c) the guideline for taking care of each patient and family, d) short-term and long-term taking care target, and e) the activity and result have according to the target. In addition, the individual daily care plan (ICP) for palliative care and caregivers (SM F2), has covered 6 steps: a) taking care of ability assessment (assess), b) patient care’s target assignment (balance and agree), c) self-care and self-management planning (create collaboration goals & care plan), d) skills development and support (develop skills & support network), e) changing management and emergency management planning (Early warning signs & Acute plan), and f) follow-up appointment.

3. The service has been assessed from the satisfaction of nurses who followed the home visit for the nursing service management model to promote self-health which can integrate with the home visit service that was easy to follow the instruction and can take to practical use. The results have shown the nurse’s satisfaction with the nursing service management model to promote self-health was around a medium to high satisfaction level (87%-89%) and the nursing service management model to promote self-health has also shown qualitative information in which palliative care patients’ PPS score has increased by 9 cases (28.12%), ADL has increased by 12 cases (50%), ESAS suffering has decreased by 18 cases, (56.25%), 22 cases have been good self- health and no complication(68.75%), 2 cases have been good dying (6.25%).